Aetna is going to disclose how much various medical test procedures cost
Good. Many don’t know how much medical care costs. This is the first step in publicizing that information.
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{ 6 comments }
No, Aetna is basically going to publish THEIR FEE SCHEDULE that they have imposed upon doctors in a take it or leave it fashion. They say that the fees are negotiated. Negotiated my coccyx! This means that insurance companies will have basically put themselves in a stronger position to enhance their profits at the expense of doctors, especially primary care physicians.
This is great! As someone who is not insured, I always pay more than everything else. Now, I’ll know how low I can negotiate. The buying power of Aetna will belong to everyone now!
The prior poster does not take into account that Aetna is a “big player” with take-it-or-leave-it heft.
Not so the prior poster, who will be laughed at if he tries to negotiate down the cost of an EKG.
Aetna will post their fee schedule in the Cincinnati area. Will they also post the average payment per code in that area? Will they also publish the additional de facto discounting they will take in the way of downcoded claims and denied claims? Will their posted figures also include the imputed discount of interest lost by claimants made by delayed settlements of Aetna claims? Will there be any accounting for the costs of resubmitting claims that are kicked back for fictitious “errors”, allowing a few more weeks to close? Just posting their fee schedule by codes tells me nothing. It tells me nothing about how claims made against those schedules are actually paid.
Telling that would really be announcing something.
Posting fee schedules is, as another has pointed out, of questionable value. The schedule represents a contractual arrangement between two parties, the carrier and the provider, and does not involve or affect any other individuals. The exception of course is those who have a policy through Aetna.
As for the one who is without insurance, I presume you own no assets of substance and do not have wages that can be attached should a medical provider decide to pursue collection for unpaid bills.
This move by Aetna is mostly window dressing, and could be in response to litigation.
Actually, I have negotiated with healthcare providers for lower rates. And, yes, my previous post was overstated in that given I lack the bargaining power of Aetna, I won’t get their rates. BUT, it’s a good bargaining tool to use with doctors. And, certainly, if more of this info. were transparent, it would decrease the bargaining power of the big insurance companies.
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